Promoting the rights of Children with disabilities innocenti digest no

from institutions to communities
Many of the initiatives that have been discussed, 
especially those relating to families and communities, 
are essential foundations for the successful 
promotion of alternatives to institutional care for 
children and adults with disabilities. These include 
the introduction of measures that reduce the 
pressure for children to be admitted to institutions 
in the first place, including the development of 
child-centred public services, accessible schools 
and the provision of local supports and services.
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These elements can be complemented by the 
development of support programmes for and by 
families and the establishment of community-based 
alternatives. These new community services can be 
developed with the active involvement of parents and 
community organizations. 
Immediate changes that might be introduced 
in existing institutions include restricting new 
admissions where alternative support structures are 
already established, improving the quality of services 
and protections against abuse, and regrouping 
children into smaller ’family style’ units, where 
girls and boys of a range of ages and abilities live 
in smaller groups with a ’house’ parent or parents. 
Sometimes such smaller family groups can be set up 
in the local community.
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Overreliance on institutional care for children in 
Central and Eastern Europe and the former Soviet 
Union has in turn encouraged a number of new 
initiatives for deinstitutionalization, with positive 
results. As an example, in the Saratov region of 
the Russian Federation, a Rehabilitation Centre for 
Disabled Children has been established with the aim 
of preventing institutionalization. The Centre sends 
out mobile teams of professionals who provide 
rehabilitation services to children with disabilities 
living at home. As in the Portage programme, they 
teach children skills to facilitate their inclusion into 
society. Family members, who are informed of their 
legal rights and entitlements as caregivers, are also 
trained to support children. The Centre has served 
many thousands of children and family members.
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(See box 6.5 for examples from Bulgaria.)
An important lesson to be drawn from these 
initiatives is that deinstitutionalization programmes 
must go hand in hand with relevant developments at 
the community level. Structures must be changed, 
appropriate long-term support mechanisms need to 
be put in place in the community, and understanding 
and acceptance of children with disabilities in wider 
society must be promoted for deinstitutionalization 
not to give rise to its own set of difficulties. For 
example, sexual and physical abuse is a risk in 
the community just as it is in institutions, and a 
child’s right to protection can be reinforced by the 
establishment of an independent oversight system to 
monitor protection issues.